How many CC would get me from a small 34B to a D? (Photo)

Thank you for your question and photo.  Unfortunately it is nearly impossible to predict final cup size prior to surgery.  I recommend that you clearly communicate your goals to a board-certified plastic surgeon and continue to "try on" implants to see what you like best.  Be sure to focus more on the "look" than the actual size of the implants.All the best,Dr. ResultsMiami, FL

Hi Bran,See the excellent answer below by Dr. Reddy.  You might want to bump it up a little beyond the 350.  I will explain this below. Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements. We put your photos on a large computer screen
for imaging, and go over your “ideal-size” photos. We then save this
information to your password protected “web account.”

First and
foremost the implant should fit the dimensions of your breast and tissue cover.
Balancing the implant to your
over-all body shape and tissue cover is essential.The main thing is to have the diameter of the implant fit the diameter of
your breast "foot print". The average size
chosen over our last 7,000 breast implants was “350cc”. BUT, 90% of our patients tell us they wish they were bigger a year after
BA. (We will see you every year for
routine checks at no charge.) It’s like your mind incorporates the "new
you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
You can try on implants in the office by
placing them into a special bra. The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues. Multiple measurements need to
be taken to fit an implant to your exact anatomy. Have your surgeon's office
show you the charts of the implant dimensions for the various profiles of
silicone and saline from the manufacturer. Then you and your surgeon can
piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan. Keep in mind
larger implants tend to have more problems over the years. Since silicone implants wrinkle less than saline
implants, they might be your best bet.

You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra. Wear this around the house for a while, and
see what you think. Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall
are taken (seven in total). Implant size
selection has been an issue of much discussion.


Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively. Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery. In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover. Finally,
your verbal requests are factored into the analysis.

We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals. It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than traditional
approaches, and it dramatically reduces pain and recovery time. In published
studies of BA patients, 95-percent of women interviewed after the procedure
returned to normal daily activities within 24-hours. Quick-recovery BA is not a
“gimmick.” These specialized techniques,
which actually speed recovery and get you back to your daily routine, kids and
work, are published in our plastic surgery journals. Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.

Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons). Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Be sure the PS has been in practice for a
while, about 20-years might be a good gauge.
Does the PS offer all three incisions?
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach."
Ask to see their before and after photos if you didn’t see any on their
website. If they are experienced, they should have several 100 breast
implant patients for you to view. I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you. You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.

All the best, “Dr. Joe”

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.

It would be really helpful to have a full consultation with breast measurements taken. Using this information, your plastic surgeon can help you chose the appropriate implants and the " look" you are going for and advise you on other adjunctive procedures  to give you your desired look. There is no ideal correlation with volume of an implant and "cup size" due to many variables including the patient current breast volume and breast shape.

The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit
at a preoperative visit will help you and your surgeon choose the optimal
implant.
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 34 D and a 38 D are significantly different. Cup size
varies from manufacturer to manufacturer and even within styles from any
particular manufacturer.
Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly what to do without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest that your plastic
surgeon be certified by the American Board of Plastic Surgery and ideally a
member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.
Robert Singer, MD FACS
La Jolla, California

There is not a direct correlation between breast implant size and cup size as the cup size varies greatly among companies and even within the same company. Moreover, cup size can vary based on who is performing the measurement. The size of the implants are based on a combination of a patient's goals and objectives and her anatomy. In order to provide a natural looking augmentation, the surgeon needs to evaluate many factors including soft tissue coverage, skin laxity, chest wall width, breast imprint width, the shape of the breasts and relative level of constriction to ensure that the breast implants are appropriate for your body.Consult in person with 3 experienced and expert board certified plastic surgeons to understand your options.

Thank you for the question and photos. I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. There is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast augmentation surgery) helps. Best wishes for an outcome that you will be very pleased with.

You have very nice normal breast anatomy and should be able to achieve a very nice result with breast augmentation.The size of implant will be determined by the measurement of the base width of your breast.Generally speaking it takes 150-200 cc of breast implant to increase by 1 cup size.  Using that figure you may well need an implant in the 350-400 cc range.  For more on sizing please read below:

How to Pick the Right Size and Shape of Breast
Implants

One of the more frequent questions I'm asked as an aesthetic plastic
surgeon for patients considering breast implants is "how do I know what
size, and shape I need?” The answer
to this question has changed dramatically throughout the 25 years that I've
been doing breast augmentation. I've also learned that the words that patients
used to describe either what they want or don't want can be completely
misleading into what I interpret their meaning to be. Therefore, I like to
request that our patients considering breast augmentation bring in photos of
both what they think they like and what they don't like. There seems to be a
multitude of sources on the Internet where these photos can be downloaded. By
looking at the patient's desires, I get a better understanding of what they
want. We no longer recommend that we place the exact implant on top of the existing
breasts and then place a stretchy bra over it to give us any idea what that
exact same implant under the muscle would produce in size. That method, in my
opinion, will always over represent what the actual result will be. If you are
going to use a sizing type method, then Mentor makes a shell sizing system such
that, when the shell size corresponding to the implant that it represents is
placed over the existing breast and in a bra, it will better represent what
that size implant under the breast and muscle will look like. We've also used
3-D imaging called Vectra® since its inception some 6 to 7 years ago. With this
method, a three-dimensional photograph of the actual patient is taken and can
be seen on a large screen television by both the physician and perspective
breast augmentation patient at the same time. We then can place all of the
different implants that are available under that image and decide what size,
shape, fill ratio, and height to base width relationships will look best for
each patient. Silicone gel breast implants come basically into shapes either
round or shaped. They also come with either a textured or smooth surface. In my
mind, there are advantages and disadvantages of every scenario and combination
of those choices. Most of the time a round smooth implant placed under the
muscle works very well for breast augmentation patients. It's then very simple
to just look at size and ratio projection to base width and select the perfect
implant for that patients shape and desire. Sometimes we would like to use a
textured surface implant. Here the advantages are that the textured surface
implants tend to migrate less in the pocket, as there is some frictional
resistance to motion. Another advantage of textured implants is that the
capsular contracture rate, especially when implants put above the muscle, is
less than for smooth wall implants. Shaped implants, because we do not want
them to turn in the pocket, are always textured. My planning method to optimize
the best implant for each patient is begun with a measurement of the base width
of the breast. We would then like to subtract about a centimeter and a half
total off of that number so as to have coverage of breast tissue over the
implant. We then will have a range of implants whose base width matches that
number. If we go larger than that number, which sometimes patients will want,
we as plastic surgeons know that these larger implants can have more problems
down the line. For instance, larger implants may migrate below the crease which
one has to lower at the time of surgery in order to get the implant in. When
these implants migrate below the natural crease, they can create a second
crease in what we call a "double bubble". Large implants can also;
because of the pressure they put on the overlying breast tissue, thin that
tissue out such that there is less overlying breast tissue over the implant as
time passes. After we have the base width, our next decision needs to be what
is the ratio of the base width to the projection of the implant. Essentially,
there are usually four choices ranging from fairly flat which is called
low-profile, to progressively more height and less width with the same volume
of silicone gel, which is called ultrahigh profile. There are two profiles in
between which are the ones more commonly used and these are called moderate
profile and moderate profile plus. Common scenarios in which taller implants
would be desired may be in patients who want a larger look than their natural
base with would allow or have a fair amount of loose overlying skin that were
trying to hold up. For patients who want a more natural look, a moderate
profile or moderate profile plus shape is more desirable. There are also
anatomically shaped implants. Rather than being around these implants can
either be taller than they are wide or wider than they are tall. There are good
reasons in patients to use either. For instance, in the patient's with very
widely spaced breasts and a large breastbone, a shaped implant that's wider
than it is tall can help hide that a little bit. Another example of the patient
in who a shaped implant would be best, is that patient with laxity after
childbirth or weight loss. When the nipple is just at the level of the
inframammary crease, we can sometimes get away with a tall implant that is
anatomically shaped such that the nipple when is it at the lower two thirds of
the breast mound created by the implant still looks good and natural and may
obviate the need for a breast lift. By spending some time, long before the
operation takes place, using the Vectra® 3-D imaging method, we can decide what
type, shape, and ratio of width to height would best serve the patient's needs.
We can then avoid what is sometimes done which is the placement of sizers at
the time of surgery. These sizers, in my opinion, have a few negative
implications. One is that there is a cost inherent in using them and usually
multiple ones are needed to make a decision as to which implant would look
best. I also believe that placing sizers in and out of the breast pocket can be
traumatic to that pocket and can cause bleeding. For me, the state-of-the-art
in today's breast augmentation is to decide long before the operation exactly
which implant would look best using computer animation. A new wrinkle into the
choice of breast implants is that breast implants now come with silicone gel
that is filled to a higher volume in the shell where it is placed. This will
allow for a round smooth implant, for instance to collapse less in the upright
position mimicking more of the look of the shaped implant. When patients show
me a photo of a very rounded upper part her breast, I would likely choose one
of these higher volumes implants such as the Natrelle Inspira® silicone gel
breast implant. Often times patients will present with breasts that are of
different sizes. One of the options to correct this is to use breast implants
of different sizes in order to best create symmetry. One of the newer methods
to help in symmetry creation is to do what we call a hybrid breast
augmentation. In the hybrid breast augmentation, the patient who has asymmetry
of the breast to begin can have matching silicone gel implants placed and the
overlying breast tissue can be made to look the same in volume and shape by
using fat grafting. In that way, no matter what the change in weight of the
patient is over time, the breast is more likely to have the same or similar
size. When it comes to symmetry, I like to tell our patients that they should
consider their breasts to be sisters that live across the railroad tracks from
each other rather than twins. With proper preoperative planning and flawless
execution of breast augmentation, this can be one of the most satisfying
aesthetic plastic surgery outcomes for both patients and physicians.